S661 Barriers to Endoscopic Access: Associations Between Sociodemographics, Patient-Reported Challenges, and Procedure Completion at a Tertiary Care Hospital

Introduction: Timely access to colonoscopy and esophagogastroduodenoscopy (EGD) is critical for gastrointestinal disease management and colorectal cancer prevention. Despite scheduling interventions disparities persist, particularly in underserved populations. While demographic predictors of access are well studied, patient-reported barriers remain underexplored. This study examines the relationships between sociodemographic characteristics, perceived barriers, and procedure completion. Methods: We conducted a cohort study of 658 patients scheduled for colonoscopy or EGD at a tertiary care center, grouped by procedure completion status. Structured telephone surveys were administered to assess patient-reported barriers. This data was integrated with sociodemographic characteristics to identify factors associated with procedure completion. Results: Completion rates were not significantly associated with age, language, insurance or median household income. Female patients were more likely to complete their procedures compared to men (61.1% vs 38.9%, P = 0.013). White and Hispanic patients had higher completion rates (22.7% and 46.0%) compared to Black (24.4%) and Asian patients (2.6%) (P = 0.007). Colonoscopy was associated with lower completion rates compared to EGD (63.1% vs 36.9%, P = 0.002). Call status was also associated with completion (P = 0.012), with English-speaking patients more likely to answer survey calls and complete their procedures compared to Spanish-speaking patients. Patient-reported barriers were significantly associated with endoscopy non-completion (completion: 93.0% without barriers vs 61.8% with barriers, P < 0.001). Health-related barriers had the strongest impact, with only 3.5% completing their procedure (P < 0.001). Life demands and scheduling conflicts also reduced completion (10.6% vs 89.4%, P < 0.001), as did transportation challenges (8.8% vs 91.2%, P < 0.001). Patients who reported not having someone to accompany them to the appointment were also less likely to complete the procedure (62.8% vs 79.1%, P = 0.031). Time-related scheduling barriers were more frequently reported by colonoscopy patients than those undergoing EGD (P = 0.044). Conclusion: Patient-reported barriers were strongly associated with procedure non-completion. Additional factors such as sex, race and language also influenced outcomes. These findings highlight the need for targeted, patient-centered interventions to address social and logistical barriers and promote equitable access to endoscopic care.